Emails and Emotions

At first I wasn’t planning on updating with anything because I didn’t think I really had anything to update about, but now I realise that I do have two things to say. Hello again, blog friends! 

The email with the results from the clinic came back, and the egg that hadn’t quite developed properly did manage to make it to the stage they wanted it to reach. So, as planned, they froze it. They categorise the quality of the blastocyst using a number and two letter system, which I will explain now:

• the numbers are the blastocyst development stage, 1-6 (with 6 being more advanced). My egg was a 2 on Wednesday but got up to a 4 by Thursday morning, meaning it had got bigger and the lining was thinning in preparation for hatching from its little membrane. 
• the first letter is the inner cell mass, which is the bit that will eventually (all other things being equal) become the foetus, graded A-C (with C indicating few cells and A meaning lots of cells were seen)
• the second letter is the part that becomes the placenta and other related tissue, with the same grading as before.

This means that the “best” embryos are of course the 4AA, 5AA and 6AA embryos; depending on whose results you look at they pretty much always have a 50-100% chance of pregnancy. In any event, AA and AB are considered “excellent” and “good” respectively, BB is “average”, and BC and CB are “poor”. CC grade blastocysts are generally considered non-viable so aren’t transferred or included in transfer/pregnancy statistics (usually!! I have a friend whose miracle CC baby is doing great and nearly 2 years old).

The blastocyst from a few years ago that would eventually go on to become my daughter was a 4BB grade: you don’t have to have excellent eggs to have excellent babies! However, the fertilised egg that they managed to freeze this time was a 4BC. As with absolutely everything else so far, this is… not at all ideal, but also not quite the end of the line just yet. Anything with a C in it significantly reduces the chances of success, so you have to be more prepared for failure than usual. My clinic has a 38% success rate with this type of blastocyst, and I have seen 33% and 35% elsewhere so this seems to be pretty average. But it’s not exactly like I have vast reserves of magically higher-quality eggs waiting to be harvested (which is a somehow alarming image) so there is little sense in going through another retrieval just on the off-chance one with a better grade shows up! Sigh. I have already spent too long looking at statistics and telling myself that everything is impossible, so I guess I’ll just leave things here on that topic for now. 

The other thing I wanted to say – and I wonder what message it sends that I have ranked it second, therefore less important, in this post – is that I’ve noticed my mental health dropping over the last few days. I mean, feeling glum about the egg results is one thing and probably to be expected, but I’ve noticed it in other areas too: less motivation, more easily irritated, less ability to deal with too many sources of stimulation at once… and to a perhaps disproportionate degree, considering everything else.

Shortly after my husband came home from work yesterday, I had a lot on my mind and was trying to do too many things at once, and therefore unsurprisingly made a mistake when cooking dinner. Everything was too noisy, there were so many things I still needed to do but not enough time to do them in (as ever!), and screwing up with the food made me throw my hands up. Gah! I don’t have time for this! 

“What’s wrong?” my husband said. “You seem in a really bad mood today.”

“I’m not,” I said. “I’m just… busy.”

“It doesn’t even all need doing right now. Stop putting so much pressure on yourself.”

And then, later on, 

“No, really, what’s up? You are definitely in a bad mood.”

“Not… intentionally? I’m just… I dunno, frustrated, stressed maybe? I don’t know. I don’t feel particularly grumpy.”

“I don’t understand what you’re stressed about. But you are super grumpy this evening.”

Later still, in the shower that night, it finally dawned on me:

Any time that mental health is referenced in regard to fertility treatment, it’s always within the specific context of people feeling the emotional strain of repeated cycles, and the heartbreak every time treatment fails to enable a couple to get pregnant. Even if that isn’t the only reason behind people’s emotional struggles, it certainly is the main one that is referred to. And that is fair and true, to a point! The emotions surrounding conception (or a lack thereof) are undeniably the peak of anybody’s IVF journey! But there is also a very simple medicinal element that I don’t really see mentioned much: I was just taking a bunch of drugs to force my body to do things it doesn’t usually do. From the ovulation-triggering hormones to the additional progesterone, for weeks I was putting myself under far more pressure than usual. And then all of a sudden, everything stopped. Just like that! Why did I expect myself to be completely even-keeled despite messing around with the chemicals in my body? With that, plus the disappointment of losing one egg, having a poor-quality second egg, and not being able to do the transfer this month like we’d originally planned… Why am I surprised that it’s taking me a bit to get back on track?

It’s so easy to tell other people to be kind to themselves and to give themselves time, but so hard to apply the same rules to yourself…